MEDICARE: DR. PATRICIA N. KLOSSMAN PHD SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SL002573L	PA

General Provider Information

NPI Number	:	1023135415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA N. KLOSSMAN PHD SLP

Provider Business Mailing Address
First Line	:	1112 BETHEL CHURCH RD
Second Line	:
City	:	SPRING CITY
State	:	PA
Zip	:	19475-9652
Country	:	US
Telephone Number	:	610-495-5429
Fax Number	:	610-495-5429

Provider Business Practice Location Address
First Line	:	1112 BETHEL CHURCH RD
Second Line	:
City	:	SPRING CITY
State	:	PA
Zip	:	19475-9652
Country	:	US
Telephone Number	:	610-495-5429
Fax Number	:	610-495-5429

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/08/2007

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